Patients will bear the heaviest consequences of proposed cuts to home healthcare

In today’s market where inflation and healthcare costs continue to rise, it is constantly difficult to identify where best to allocate a limited amount of funds.

Of course, there are no easy decisions, but consumer demand and ultimately what will make healthcare more accessible, convenient, cost-effective and better for patients must guide us.

Thus, there are some areas of care where a reduction in federal funding is simply not feasible or reasonable. Topping the list is home healthcare, a sector that has seen significant growth during and after the peak of Covid-19 and continues to innovate for the benefit of its patients.

Despite this, the US Centers for Medicare & Medicaid Services (CMS) recently proposed a permanent 7.69% reduction in Medicare home care providers, as well as a future “clawback” of provider payments for care provided in 2020 and 2021. In total, these reductions are expected to reach $18 billion in over the next 10 years, starting in 2023.

Not only do these cuts dramatically restrict the ability to provide the quality home health care that America’s seniors deserve, but they also directly contradict current home health trends and consumer preferences.

In a study this year of physicians who primarily treat Medicare fee-for-service (FFS) and Medicare Advantage (MA) patients, McKinsey estimated that $265 billion in US healthcare services for FFS and MA recipients could move from traditional facilities to patients’ homes by 2025, with no reduction in quality or access to care.

In addition, a growing number of seniors prefer to age in place with home care. End of 2021 study conducted by Interim HealthCare Inc.79% of people aged 65 and over said their quality of life would be significantly better if they could receive health care at home rather than in a hospital or nursing home.

In response to this growing and anticipated demand, providers have increasingly recognized the important role that digital health technology plays in scaling efficient and cost-effective home health services for the benefit of patients.

While much of this technology has focused on the important function of caregiving, home care providers and others are increasingly investing in “interoperability technologies” that better connect them with their acute care counterparts, and vice versa.

This idea of ​​interoperability creates a more robust healthcare ecosystem, where the exchange of patient data and health outcomes between systems enables a smoother care experience for patient, payer and provider. These are long-awaited advances for the home health industry, and the entire continuum of care, that could be halted by reduced funding.

For the patient, this could mean delays in phone calls and faxes or days (or weeks) of waiting for referral documents to be processed so they can get much-needed care faster. after leaving the hospital or seeing their primary care physician.

For providers and payers, this data exchange allows payers to better see and measure the quantifiable value of home care providers that payers have been missing, helping them provide appropriate reimbursement rates based on data and facts. .

And beyond a more integrated system, this technology has automated administrative tasks and fostered a leaner business model for vendors. For example, in 2020, VNS Health reduced its accounts receivable by 50%, from $16 million to $8 million, by integrating interoperability technology. They also saved $90,000 by eliminating temporary staffing departments dedicated to administrative work.

All of these factors translate into a more connected and robust healthcare ecosystem, where patients avoid unnecessarily long and costly hospital stays and have access to convenient and timely post-acute care. In addition, payers and suppliers benefit from a healthier bottom line.

The cuts offered by CMS stop that momentum in its tracks and reverse the growth and innovation that results in better, more efficient home healthcare. Recently introduced legislation that proposes delay cuts until 2026 is a more reasonable approach.

Payers must remain well-equipped to respond to these changing patient preferences, just as providers have. If they don’t, patients and their loved ones bear the brunt of fragmented and costly care.

Photo: Nuthawut Somsuk, Getty Images

About Margie Peters

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